Meet our patient Bob and hear his insights into the dental implants process.

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General
Insurance
Surgery
Pre-Surgical
Post-Surgical
Recovery

General

What is a dental implant?

A dental implant is a substitute tooth root that serves the same function as a natural tooth root. It preserves bone and provides a stable foundation for a replacement tooth that looks, feels, and functions like a natural tooth. Dental implants are made of titanium, which is a biocompatible material used in orthopedic implants. 


Why are dental implants better than bridges, partials, and dentures?

Dental implants can last a lifetime, unlike bridges, partials, and dentures that may need to be replaced several times. Since dental implants prevent the bone resorption that occurs when teeth are missing, the natural appearance of the smile is preserved. With implant treatment, there is no compromise to adjacent teeth; they are not cut down to place a bridge or loosened by the hooks on removable partials. Dentures and partials have the added disadvantage of accelerating the bone resorption process, which causes the appearance of premature aging.

 

Is anyone ever considered too old for dental implants?

Overall health and a desire to improve one's quality of life are much more important considerations than age. When dental implants were first developed back in the 1950’s, implant supported replacement teeth were originally designed as a solution for older patients who were missing all of their teeth. Since then, many patients well into their nineties have had dental implant treatment without a single problem.
 

Are there any medical conditions that would cause instances in which the All-on-4 procedure cannot be utilized?

We employ a Board Certified oral surgeon who is also trained and licensed as an MD. He or she will work closely with any patient who may have contraindications for implant placement; however, the vast majority of people are candidates for the All-on-4 procedure. As with all medical procedures, we thoroughly evaluate each person and contact their physician should any questions arise.

Will there be any restrictions to my lifestyle?

No. After a five-to-six-month healing period, you will be able to undertake any activity that you would with normal teeth. This includes eating and drinking whatever you choose. Your new replacement teeth will look, feel, and function like natural teeth, which will allow you to forget about them and enjoy life as it was meant to be enjoyed.

Will my new teeth look natural?

Your new replacement teeth will look, feel, and function like natural teeth. And since implant treatment is the only solution that prevents bone resorption, which can cause your smile to look unnatural, the long-term esthetics will be superior to any other treatment option.

Who is a candidate for dental implant treatment?

Nearly everyone who is missing one or more teeth and is in general good health is a candidate for dental implant treatment. There are a few medical conditions that can undermine the success of implant treatment, such as uncontrolled diabetes. However, there are very few conditions that would keep someone from having implant treatment altogether.

Is the surgical procedure painful?

Most implant patient's report that the discomfort is far less than they expected and is very much like having a tooth extracted. Moreover, although everyone is different with regards to pain tolerance, most patients are very comfortable simply taking Tylenol afterward.

Is it necessary to have one implant placed for each missing tooth?

No. In fact, it is possible to replace all of the lower teeth with an overdenture that is supported by only 2-4 implants. On the other hand, some dental specialists feel that it is advantageous to replace missing posterior teeth with individual implants to provide additional strength to withstand the forces of chewing for patients who have most of their natural teeth.

Each patient’s situation is unique and should be evaluated by a dental specialist to determine the appropriate number of implants required to support the replacement teeth that will meet the patient’s functional and esthetic needs.
 

How long do implants last?

Documented clinical research demonstrates that implant supported replacement teeth have been successful for over 50 years. These were some of the first root-form implant cases ever completed and they have been closely monitored from the beginning. It is highly likely that these cases will be successful throughout the lifetime of those patients.

Do dental implants ever fail?

Dental implant treatment is one of the most successful procedures in the medical-dental field, with documented success rates over 98%. Although successful treatment is very predictable, there are rare occasions where the bone does not completely bond to the implants. When this occurs, new implants are placed and the success rates for the replacement implants are even higher.

Smoking or putting too much pressure on newly placed implants, as with excessive grinding of the teeth, can cause problems with the bone bonding to the implants and should be avoided.

Does the body ever reject dental implants?

Several years ago there was quite a scare about certain types of breast implants, which has caused a number of people to ask if the same thing is possible with dental implants.

As indicated above, the success rates for dental implants are extremely high. This is due in part to the fact that root-form implants are made of a biocompatible material - titanium. Because titanium is accepted so well by the human body, it also used for orthopedic implants, such as hip and knee replacements.

If dental implants preserve bone, why would a dentist recommend a tooth supported bridge?

Naturally, since dental implants preserve bone, if a patient qualifies as a candidate, implant treatment is usually considered the treatment of choice. Now that implants are considered standard of care, it is much less common for dentists to recommend fixed bridges instead of implants. Some dentists recommend bridges for patients who are not candidates for implants, or when patients insist on having the lowest possible fee for tooth replacement.

However, even in cases where the teeth adjacent to the missing tooth/teeth have restorations, many dentists do not want to grind these teeth down into peg shapes to fit a bridge, as this compromises the long term health of those teeth. Furthermore, most dentists abhor the idea of grinding down perfect teeth without restorations to place a traditional bridge, and therefore, will almost always recommend dental implant treatment for such cases.

Are there situations where extracting a tooth and replacing it with an implant would be recommended?

There are many situations where natural teeth are either failing or are about to fail. This includes severe periodontal disease (gum disease) that has eroded the bone that supports the teeth. Sometimes in these cases, it is preferable to extract the teeth; eliminate the disease and infection, and replace the teeth with implant supported crowns/bridges.

There are also situations where a tooth has had a root canal (nerves have been removed from the tooth) leaving the tooth brittle and susceptible to fracture. In cases where the tooth needs to be retreated and the prognosis is not favorable, it is preferable to extract the tooth and replace it with an implant supported crown.

Teeth with severe fractures are usually extracted and are ideal candidates for replacement with dental implant treatment.

 

What is involved with taking care of dental implants?

The home care recommended varies depending upon the type of implant supported replacement teeth. For example, a single implant supported crown is cleaned like a natural tooth, with regular brushing and flossing. Implant supported bridges that replace a few teeth are cleaned like tooth supported bridges, brushing and flossing with a floss threader.

Home care is a little more complicated for people who are missing all of their teeth, in that special brushes and floss are often recommended. With overdentures, it is necessary to clean the implant attachments, as well as the overdenture. Permanently fixed implant supported replacement teeth are cleaned like all other bridges.

In all cases, it is recommended that patients see their regular dentist and hygienist at least twice each year unless they routinely see the periodontist, in which case they would continue to alternate visits. It is usually recommended that the patient see the surgical specialist who places the implant(s) at least once each year as well. These visits, combined with proper home care, are essential to the long term success of implant treatment.

Will there be any restrictions to my lifestyle?

No. You will be able to undertake any activity that you would with normal teeth. This includes eating and drinking whatever you choose. Your new replacement teeth will look, feel, and function like natural teeth, which will allow you to forget about them and enjoy life as it was meant to be enjoyed.

Insurance

Is dental implant treatment covered by dental insurance?

Insurance coverage of implant treatment depends on the individual policy. However, it is rare to receive any substantial coverage. Since the benefit coverage is determined strictly by the amount the employer wants to spend on the policy, and the insurance companies want to build in their profit margins, there are major limitations on most dental insurance plans. In reality, the plans are only designed to cover routine maintenance, emergencies, and basic care.

The insurance companies use statistical data to determine the most common procedures submitted on claims, and then they set their own usual and customary fee schedule for these procedures. They also determine the specific restrictions and limitations for each plan. Because the plans are only intended to cover the basics, there is an annual maximum allowable benefit of $1,000-$1,500 on most plans.

Although most companies exclude implants as a covered benefit, many of them will pay the same benefit they would cover for the lowest cost alternative treatment option (partials and dentures) and some of the diagnostic records, if a specific request is made for alternative benefits. Even if an individual policy includes implants as a covered benefit, the amount of coverage is still limited to the annual maximum allowable.

Does medical insurance cover implant treatment?

There are a few cases where medical insurance is available for people who are missing all of their teeth, and as a result, have medical complications. This type of coverage depends solely on the individual policy. Other than these situations, medical coverage is very rare.

Work related injuries and other types of accidents are the other cases that are sometimes covered by insurance. Medicare does not cover implant treatment. All in all, it is best to assume that there is no medical insurance coverage available.

Are any surgical procedures covered under medical benefits? My dental benefits are limited to $1,500.00 per calendar year.

Typically, medical insurance will cover implant/tooth replacement procedures related to the following types of conditions:

  1. Trauma - say you lose your front teeth after a car accident
  2. Loss of teeth due to a medical condition
  3. If teeth are lost in the course of tumor treatment
  4. A congenitally missing tooth.
     

Are anesthesiologist’s fees billable to medical insurance?

At EON Clinics, the oral surgeon administers the anesthesia, which is included in the fee.

Surgery

What anesthesia will be used? How will it be administered?

The patient and surgeon will discuss anesthesia options. It is our goal to provide state of the art care with minimal discomfort. Local anesthesia (a drug such as lidocaine) can be injected at the surgical site. If the operation is more involved, sedation will be used via an IV placed in the arm or hand.

Will vital signs be monitored?

Yes, with sedation the oral surgeon and surgical assistants will continuously monitor the vital signs.

Will sedatives and/or anti-anxiety medication be used? Which one(s)?

With IV sedation, all of the drugs have anxiolytic (anti-anxiety) and sedative properties designed to relax you. These include Propofol, Versed, and possibly a narcotic such as Fentanyl. A preoperative oral sedative can be prescribed in some cases.

What type of pain management will be administered?

During the procedure, a local anesthetic to help block pain, such as lidocaine, will be given. Following the procedure, a combination of adequate pain medications, mixed with a non-steroidal anti-inflammatory such as Ibuprofen, will be prescribed.

What is estimated length of surgery?

Single tooth implants can be placed in less than 30 minutes, multiple tooth implants can be up to an hour, while a full jaw could take 2-3 hours.

 

Are implants placed within the gum line so that natural gums are visible/grow over implants, or, are implants constructed with artificial gums and placed over natural gums (similar to traditional dentures)?

Placement of the implants depends on many factors, with outstanding results. The surgeon and prosthodontist, along with the patient’s input, will decide which option is best

Is there much blood loss?

It is extremely very rare to have significant blood loss.

If jaw bone density was evaluated and found appropriate prior to surgery, is it possible to find inadequate bone density during surgery and further exploration, resulting in inability to complete the procedure? What alternatives are available if this should occur?

In these rare occasions, either immediate bone grafting or staged bone grafting can correct the problem. The key is to hold off on implant placement if the chance of Osseointegration (the implant fusing to the bone) is poor.

How many implant procedures has your team placed?

EON Clinics’ clinicians have placed and restored thousands of implants, all with success rates greater than 97%.

Pre-Surgical

Will antibiotics be prescribed prior to surgery? What kind? For how long?

Most oral surgeons do not prescribe preoperative antibiotics, however antibiotics given at the time of surgery via IV may be indicated. We will commonly use antibiotics such as clindamycin and amoxicillin that kill bacteria found in the mouth known as oral flora (an oral bacterium). The specific drug used will depend on the operation and the allergy profile of the patient. A short post-operative course of antibiotics is almost always prescribed.

Are there any medications and/or vitamins that need to be avoided? If so, for how long?

Prior to surgery you will discuss your medications with your surgeon. Aspirin, and other types of blood thinners such as Coumadin, should be stopped a week before the operation as it can increase bleeding. Most other medications should be continued. Again, it is very important to discuss these and other medications with both your primary care doctor and your oral surgeon before the implant procedure.

Are there food and drink restrictions prior to surgery?

Food and drinks restrictions prior to surgery only apply  if the patient is being sedated. In this case, the patient should not consume anything, including water, 6-8 hours prior to the procedure.

Post-Surgical

How long do I need to stay at your office following surgery? What criteria must be met before I will be released to go home?

If sedation is used we will have you stay approximately 20 minutes. The patient must be alert and oriented prior to leaving by assessing vital signs and mental status at regular intervals. Basically, you can be tired when you leave but you should be alert.

What pain medication will be prescribed? Which one(s) and for how long?

Most prescribed drugs include Percocet or Vicodin for 3-5 days post-operative.

Will antibiotics be prescribed following surgery? Which one(s) and for how long?

In most cases, depending on the procedure itself, amoxicillin or clindamycin is prescribed for 7 days post-operative. We also recommend using an antimicrobial mouth rinse called Peridex for 1 week.

Recovery

How long will I need to be off work?

Depending on the extent of the procedure and what you do for work, anywhere from a matter of hours to 4 days.

Is there likely to be any facial bruising?

There can be some bruising, particularly if many teeth are removed and numerous implants placed. Women and light skinned individuals may bruise more.

When can I resume fluid intake, soft food, and normal food?

Clear liquids can be started immediately. Patient’s diet will be determined based on the extent of the surgery and recovery protocol.
 

Are there restrictions for activities? Driving?

With sedation there should be NO driving until the following day. Depending on the extent of surgery, and in the most severe cases, curb strenuous activities for 7 days.

How soon do I need to return to office for post-surgical follow-up?

Within one week, depending on the case. Your implant coordinator will determine your recall visits and our post-operative staff will keep you informed of your appointments.